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belshire 25971 Towne centre Drive <br /> Foothill Ranch , CA 92610 <br /> environmental services, inc. ( 949 ) 460-5200 <br /> Tank Secondary Containment Integrity Testing <br /> Facility : Costco Wholesale - TRACY - 0658 Date: 9/24/2020 <br /> Address : 3250 W . Grantline Rd Testing Company : Belshire Environmental Services , Inc . <br /> City, State , Zip : Tracy , CA 95377 Tester Name : Jeff Badders <br /> This test is performed in accordance with PEI / RP1200 . See Section 4 . 2 for the test method and procedures . <br /> Tank ID T1 87 T2 87 T3 91 T4 Additive <br /> Exempt from Testing Yes Yes Yes Yes <br /> Tank Manufacturer <br /> Tank Capacity <br /> Tank Material <br /> Product Stored <br /> Test Start Time <br /> Initial Vacuum Reading <br /> Specified Test Duration <br /> (See Duration Table Below ) <br /> Test End Time <br /> Final Vacuum Reading <br /> Test Duration <br /> Vacuum Change <br /> Pass/fail criteria : No reduction in vacuum allowed for a passing result . <br /> Test Results : Ql Passl_� Fail ❑ Pass EA Fail ❑ Pass E) Fail Pass [b Fail D PassD Fail <br /> Comments : <br /> Exempt From Testing - Continuously Monitored <br /> Test Duration Table <br /> Tank Capacity Duration <br /> Less than 20, 000 Gallons 1 Hour <br /> 20, 000 gallons or more 2 Hours <br /> Technician Signature : � ; ' � �� ,, Date : 9/24/2020 <br /> Rav Q/98/2018 <br />